This is a really difficult point of discussion, but something that is so important to get out there for women who have experienced the tragedy of pregnancy loss. First of all, it is common- we will just get the numbers out of the way to start – overall, it’s estimated that 1 in 10 of all “clinically recognized” pregnancies – a.k.a. when a woman takes a pregnancy test and it’s positive, end in miscarriage, and the majority of these are in the first 12 weeks. The numbers of all pregnancy loss are probably higher, as many miscarriages occur before a woman even knows she is pregnant. Over half of known miscarriages are due to genetic problems- sometimes that spontaneously occur as the baby is developing (when cells are dividing, errors can occur in the process) and sometimes, the parents can be carriers of genetic abnormalities and not even know it.
The risk of pregnancy loss increases as maternal age increases – in part due to exposures throughout a woman’s lifetime that increase the risk of genetic abnormalities as the baby is forming. Here are some additional numbers based on the mother’s age when conceiving:
- For women age 20-30, the risk of miscarriage for a given pregnancy is 9-17%
- For women over 35 this goes up to 20%, at age 40 the risk is 40% and by age 45 the risk is a staggering 80%.
A question I get a lot is, “I’ve had one miscarriage, what is my risk of having another?” Generally speaking, after one miscarriage your risk of another is only around 1%. If you have a second miscarriage, your risk of a third is about 26% and after a third miscarriage it’s 28% chance that you could have another. There are many, many reasons someone may have recurrent miscarriages- you or your partner could be silent carriers of genetic abnormalities (you can both be completely healthy but have some sperm or eggs that have changes in the genes they carry), there can be problems with the uterus itself and it’s ability to allow an embryo (fertilized egg and sperm) to attach or production of the hormones that allow embryos continue to grow, certain medical problems or poor health can lead to repeated loss, and 50-75% of the time, we can’t find a reason for repeated pregnancy loss.
People often wonder, “when should I be evaluated for repeated miscarriages?” Between 2-3 repeated miscarriages, a full evaluation for some of the causes discussed above is warranted.
The most important piece that hasn’t been discussed yet is the emotional toll that these losses take on women and families. Many times when no cause can be found it is very draining for a couple who repeatedly looses pregnancies to continue to try, but 65% of these people will have a successful next pregnancy. Make sure you surround yourself with love and support, and consider counseling if you are feeling in despair after a loss. It is a tragedy that everyone copes with in different ways, so don’t be afraid to seek out someone to help you deal with the feelings after this if you are having a difficult time.